Evidence mapPaperPMID 22018679Full record

ArticleClinical therapeutics2011

Evaluating the long-term cost-effectiveness of liraglutide versus exenatide BID in patients with type 2 diabetes who fail to improve with oral antidiabetic agents.

William J Valentine, Andrew J Palmer, Morten Lammert, Jakob Langer, Michael Brändle

Registry-linked trialAbstract readValidation Study
PubMed Publisher
In one paragraph

Article in Clinical therapeutics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00518882. Cited by 14 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 4 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00518882 phase3completed

Effect of Liraglutide or Exenatide Added to a Background Treatment of Metformin, Sulphonylurea or a Combination of Both on Glycaemic Control in Subjects With Type 2 Diabetes

Ran2007Enrolled467Registered outcomes55Posted comparisons85ConditionsDiabetes, Diabetes Mellitus, Type 2Armsexenatide, liraglutide
Open the trial in the graph
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Review
  6. Review
  7. Health economic evaluation of type 2 diabetes mellitus: a clinical practice focused review.Clinical medicine insights. Endocrinology and diabetes · 2015
    Review
  8. Article
  9. Review
  10. Article
  11. Review
  12. Glucagon-like peptide-1 analogues: An overview.Indian journal of endocrinology and metabolism · 2013
    Article
  13. Article
  14. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 3 countries.

William J ValentineOssian Health Economics and Communications GmbH, Basel, Switzerland.
Andrew J Palmer
Morten Lammert
Jakob Langer
Michael Brändle
Kantonsspital St. Gallen · CHNovo Nordisk (Denmark) · DKNovo Nordisk (Switzerland) · CHUniversity of Tasmania · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe global clinical and economic burden of type 2 diabetes is substantial. Recently, clinical trials with glucagon-like peptide-1 (GLP-1) receptor agonists (liraglutide and exenatide) have shown a multifactorial clinical profile with the potential to address many of the clinical needs of patients and reduce the burden of disease.

objectiveThe goal of this study was to evaluate the long-term cost-effectiveness of once-daily liraglutide versus exenatide BID in patients with type 2 diabetes who failed to improve with metformin and/or sulfonylurea, based on the results of a previous clinical trial in 6 European countries (Switzerland, Denmark, Norway, Finland, the Netherlands, and Austria).

methodsA validated computer simulation model of diabetes was used to predict life expectancy, quality-adjusted life years (QALYs), and incidence of diabetes-related complications in patients receiving liraglutide (1.8 mg once daily) or exenatide (10 μg BID). Baseline cohort characteristics and treatment effects were derived from the Liraglutide Effect and Action in Diabetes 6 trial. Country-specific complication costs were taken from published sources. Simulations were run over 40 years from third-party payer perspectives. Future costs and clinical benefits were discounted at country-specific discount rates. Sensitivity analyses were performed.

resultsLiraglutide was associated with improvements of 0.12 to 0.17 QALY and a reduced incidence of most diabetes-related complications versus exenatide in all settings. Evaluation of total direct medical costs (treatment plus complication costs) suggest that liraglutide was likely to cost between Euro (€) 1023 and €1866 more than exenatide over patients' lifetimes, leading to incremental cost-effectiveness ratios per QALY gained versus exenatide of: Switzerland, CHF (Swiss francs) 10,950 (€6902); Denmark, Danish krone [kr] 88,160 (€11,805); Norway, Norwegian krone [kr], 111,916 (€13,546); Finland, €8459; the Netherlands, €8119; and Austria, €8516.

conclusionsLong-term projections indicated that liraglutide was associated with benefits in life expectancy, QALYs, and reduced complication rates versus exenatide. Liraglutide was cost-effective from a health care payer perspective in Switzerland, Denmark, Norway, Finland, the Netherlands, and Austria.

Indexed as

Cost-Benefit AnalysisAdministration, OralCohort StudiesDiabetes Mellitus, Type 2Drug Administration ScheduleExenatideGlucagon-Like Peptide 1HumansHypoglycemic AgentsLiraglutideMiddle AgedPeptidesQuality-Adjusted Life YearsVenomsExenatideGlucagon-Like Peptide 1Hypoglycemic AgentsLiraglutidePeptidesVenoms

Identifiers

PMID22018679
OpenAlexW2046964049

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.